The Epidemiologic Assessment of Children with Acute Pyelonephritis in a 5-Years Period, Based on American Academy of Pediatrics (AAP) 2011 Guidelinee

Document Type : Original Article (s)

Authors

1 Professor, Infectious Diseases Research Center with Focus on Nosocomial Infections, Mazandaran University of Medical Sciences, Sari, Iran

2 Assistant Professor, Department of Epidemiology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran

3 Student of Medicine, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran

Abstract

Background: Acute pyelonephritis (APN) is the second common significant infection in infants and children. Long-term complications of APN, scar nephropathy and hypertension, make it a serious disease at this period of life. American Academy of Pediatrics (AAP) suggested newer approach to patients with APN from 2011. We studied the epidemiologic aspect of the patients since 2011.Methods: This retrospective study was performed by assessing the documented history of patients with APN. Patients' demographic and clinical data were recorded. Age, sex, urine culture, sensitivity status, and imaging findings were analyzed. Long-term findings such as recurrent urinary tract infection (UTI), kidney scar, and outcome of vesicoureteral reflux were assessed.Findings: A total of 360 children with mean age of 35.2 months, (81% female) were enrolled in study. The most common organism was Escherichia coli (78%) with at least 82% sensitivity to third generation cephalosporins, aminoglycosides, and carbapneme. The resistance of Escherichia coli to co-trimoxazole and nalidixic acid was 44% and 38%, respectively. 26 patients (7.6%) suffered from recurrent UTI; and recurrence was related patient's age. Hydronephrosis, vesicoureteral reflux, and scar were respectively reported in 20%, 46%, and 47% of children imaging were performed for them.Conclusion: APN is a serious and significant infection in children yet. The most common organism is Escherichia coli. Long-term complications confirm that strict follow up and assessment of the patients is very advisable.

Keywords

References

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Journal of Isfahan Medical School
Volume 35, Issue 432 - Serial Number 432
March and April 2017
Pages 635-642

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History

  • Receive Date: 16 February 2017
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

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